Multilevel Coblation Therapy of OSA in Long Face Syndrome

Abstract

Objective: Evaluate the efficacy and safety of multilevel coblation surgery in patients with sleep-disordered breathing (S-D B/OSA) and in Long Face Syndrome and to understand these rare presentations for effective management.

Method: Evaluate 5 Long Face Syndrome and 182 consecutive S-BD patients, who had 423 coblation surgical procedures from October 2006 to September 2010. Multilevel S-BD surgery was performed at nasal level (turbinate reduction, functional endoscopic sinus surgery, septorhinoplasty), palate level (somnoplasty, pharyngoplasty, coblation UPPP), and tongue base reduction.

Results: A total of 187 patients had adequate follow-up, A total of 124 men and 63 women, with mean age of 47 years and mean BMI 30.2. ESS Score has improved from 16 ± 2 to 4 ± 2. The AHI improved in the patient with Long Face Syndrome from 69.3 to 11.8 and the patient is nondependent on CPAP. The overall complication rate 3.64%, none of the patients had any airway compromise requiring ICU care. The major complications include (a) two patients had palatal ulceration, (b) one negative pressure pulmonary edema (c) one patient had secondary hemorrhage (aspirin). Patients that had tongue procedure required overnight stay.

Conclusion: This study illustrates that multilevel coblation surgery provides a minimally invasive technique with less morbidity and has good outcome for moderate to severe OSA. Long Face Syndrome is very rare in which primary surgery may be considered.